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Health Implications Of Heavy Metal Contamination In Commercially Available Deodorant And Antiperspirant Products Sold In Benghazi, Libya, Maysson Yaghi, Khaled Elsherif

Al-Bahir

The extensive usage of deodorants and antiperspirants raises concerns about the potential health risks posed by heavy metal content. This study quantified the levels of five heavy metals: Aluminum, Zirconium, Lead, Cadmium, and Chromium in 22 commercial products widely used in Benghazi, Libya, and assessed the associated health risks. Samples, categorized into gel, stick, and roll-on formulations, were analyzed using iCAP TQ ICP-MS. Al and Zr showed the widest concentration ranges, reflecting their intentional use as active ingredients. Al levels ranged from trace amounts (0.032 mg/kg) up to a maximum of 99.10 mg/kg, while Zr was found exclusively in gel …

Takotsubo Cardiomyopathy In A 55-Year-Old Female With Atypical Chest Pain And A History Of Autoimmune Disease, Carrie Greene, Dana Mathew

Florida Journal of Emergency Medicine (FJEM)

A 55-year-old woman with rheumatoid arthritis and supraventricular tachycardia presented with acute chest pain radiating to the back/left shoulder, with nausea and lightheadedness. Initial ECG showed inferior–lateral ST-segment elevation with reciprocal depressions; within 90 minutes the STE resolved with new incomplete RBBB and diffuse low voltage. High-sensitivity troponin rose (delta ~270 ng/L). Point-of-care and formal echocardiography revealed LV wall-motion abnormalities. Emergent catheterization showed no obstructive CAD (<30% distal OM) with apical ballooning and EF 40–45%, consistent with Takotsubo cardiomyopathy; cardiac MRI confirmed myocardial edema. She was managed with anticoagulation initially, telemetry, and supportive care, and recovered uneventfully with normalization of function on follow-up.

ED Takeaways

• TTC can mimic STEMI with transient STE and conduction changes.

• Troponin rise + non-obstructive coronaries should prompt consideration of TTC.

• Consider TTC in post-menopausal women and those with autoimmune disease; use …

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Meningococcemia In Boy With Dense Deposit Disease Receiving C5 Complement Inhibitor Ravulizumab, Andrew Gonedes, Alexandra Martinez, Allan M. Greissman, Hanan Atia, Eric Boccio

Florida Journal of Emergency Medicine (FJEM)

No abstract provided.

Complete Atrioventricular Block In A Heart Transplant Recipient, Jalyn Joseph, Morgan Reel, Eric Boccio

Florida Journal of Emergency Medicine (FJEM)

Complete atrioventricular (AV) block, though uncommon in heart transplant recipients, is a potentially life-threatening condition that demands rapid diagnosis and management in the acute care setting. During complete AV block, there is a failure of electrical conduction from the atria to the ventricles resulting in the independent and dyssynchronous contraction of the heart chambers. Due to the resultant decrease in cardiac output, patients may experience lightheadedness, fatigue, shortness of breath, syncope and near syncope, and, in severe cases, cardiogenic shock may develop. A 58-year-old female with past medical history including hypertension, diabetes, chronic kidney disease, and congestive heart failure and …

Distinguishing Acute Cardiac Events From Chronic Troponin Elevation: Integrating High-Sensitivity Troponin Trends With Objective Ischemic Evidence Under The 4th Udmi Across Diverse Renal Function Profiles, Aidan Fernandez, Amanda Green, Silvija Milanovic, Eric Han, Asia Elbooz, Michael Petrauskis, Justin Nippert, Michael Marchick, Nicholas Maldonado, Mohammed Ruzieh, Elizabeth Warren, Matthew Shaw, Lars Beattie, Brandon Allen

Florida Journal of Emergency Medicine (FJEM)

The Fourth (4th) Universal Definition of Myocardial Infarction (UDMI) provides a standardized framework to enhance diagnostic accuracy and clinical decision-making. However, challenges can arise due to the use of subjective clinical assessment in diagnostic criteria or in the presence of impaired renal clearance. This study modifies the 4th UDMI by requiring objective ischemic evidence to improve consistency in myocardial infarction (MI) classification and applies it across diverse patient populations.

In this retrospective study, patients who presented to the emergency department (ED) with 99th percentile high sensitivity cardiac troponin (hs-cTn) values were classified using the modified 4th UDMI into the categories …

Unexpected Companions: Appendicitis And Bilateral Testicular Torsion, Jc Alvarenga, Melissa Kirk, Michelle Osorio-Rodriguez

Florida Journal of Emergency Medicine (FJEM)

Abdominal pain is a frequent chief complaint in the emergency department (ED), responsible for 5% of all visits yearly. Despite emergency room work ups, 25% of these cases go undiagnosed. In the pediatric population, abdominal pain can be even harder to differentiate with causes ranging from low acuity constipation to emergent surgical emergencies like torsion or appendicitis. During these visits, the likelihood of two emergent surgical diagnoses occurring concurrently is a rare and often overlooked occurrence.

This case describes a 15-year-old male with a chief complaint of nausea and vomiting starting several hours prior to arrival. In the ED, history, …

Building Resilience One Connection At A Time: A Guide To Developing Retention Programming On College Campuses, Stephanie Sibley, Rachel Daltry

Journal of Access, Retention, and Inclusion in Higher Education

Despite college students having the potential to be more socially connected than ever before thanks to technology and social media, many students still struggle with isolation, loneliness, and a lack of belongingness and community. These feelings and experiences not only increase the risk for suicidal behavior and diminish resilience, but they can also negatively impact student retention. Outreach programming that targets social connectedness will be described. Specific guidelines developed from first-hand experiences with implementing such programming will be highlighted, and readers will be encouraged to consider how similar programming could be implemented by various offices or personnel at their own …

Bridging The Gap: Exploring The Impact Of Graduate Preparation Programs On Undergraduate Stem Students, Faika Tahir Jan, Thomas Nelson, Travis Chan, Tremayne O. Waller, Cynthia Hampton, Sherif Abdelhamid

Journal of Access, Retention, and Inclusion in Higher Education

This study explores the impact of the "A Step to the Doctorate" (S2D) program on the academic trajectories of undergraduate STEM students, focusing on how it fosters academic success and prepares participants for graduate education. Drawing on data from pre and post surveys and semi structured interviews of 60 participants, the research addresses two primary questions: (1) Which program components do participants find most impactful? Moreover, (2) How has the program influenced their academic aspirations and preparedness for graduate school? The findings highlight that mentorship, peer networking, and targeted workshops are key in boosting academic self-efficacy and enhancing participants’ confidence …

The Success Equation: Scaling The Pivot Framework For Stem & Healthcare Student Success, Ryan Clark, Jarrod Lockhart

Journal of Access, Retention, and Inclusion in Higher Education

Student success in STEM and healthcare increasingly depends on intentional design of equitable, scalable pathways that integrate structured programming, immersive experiential learning, and modern workforce-aligned upskilling. This manuscript introduces the PIVOT Framework— Pathways, Innovation, Vision, Opportunity, and Transformation—as a comprehensive, evidencedriven model for reimagining student success strategies in STEM and healthcare education. The framework emphasizes early engagement, longitudinal support, and competency-based preparation, ensuring students develop the skills and professional identities necessary for success. Drawing from a range of high-impact practices—including paid internships, research-based learning experiences, mentoring structures, digital skills integration, and stackable credentialing—the manuscript demonstrates how coordinated institutional strategies improve …

Rethinking Academic Integrity: Deconstructing Academic Norms In A Technologically And Culturally Shifting Lanscape, Ilknur Sancak-Marusa

Journal of Access, Retention, and Inclusion in Higher Education

The rise of generative AI use in higher education calls for a critical reexamination of academic integrity, revealing its culturally-constructed and context-dependent nature. While institutions scramble to create generative AI policies, many rely on Western-centric definitions of integrity that overlook the diverse cultural and linguistic students’ backgrounds. Traditional frameworks often misunderstand behaviors like patchwork writing or collaborative learning, viewing them as misconduct rather than culturally influenced practices. This paper argues that academic integrity standards differ across cultures and institutions rather than follow universal principles. As generative AI further complicates ideas of authorship and originality, institutions must move beyond punitive responses …

Editor's Note, John B. Craig

Journal of Access, Retention, and Inclusion in Higher Education

No abstract provided.

Acquired Methemoglobinemia Secondary To Oral Ingestion Of Alkyl Nitrite, Larissa L. Tavares, David Neff, Christopher Didonato, Atul Sofat, Eric Boccio

Florida Journal of Emergency Medicine (FJEM)

Methemoglobinemia is a potentially life-threatening condition in which the ferric state of hemoglobin impairs oxygen transport, leading to refractory hypoxia. While most cases are acquired through exposure to oxidizing agents, this report details a rare case of acquired methemoglobinemia complicated by severe hypotension and pulmonary edema secondary to the oral ingestion of alkyl nitrite, colloquially known as a “popper.”

A 54-year-old male presented to the emergency department after orally ingesting an alkyl nitrite product, believing it would be more effective than inhalation. Shortly after, he developed dizziness, dyspnea, and dusky skin, and was found to be hypotensive and hypoxic. Initial …

Disaster Exercise: Evaluating Mci Triage Training, Michael J. Steflovich Jr, Jodie Stobierski, Alexis Davis, Natasha Pavlinetz, Nela Isic, Nicole Roberson, Earl Best Md

Florida Journal of Emergency Medicine (FJEM)

Abstract

Study Objectives

The primary objective of this study was to evaluate the effectiveness of a didactic lecture-based training on mass casualty incident (MCI) triage performance among first- and second-year medical students. Specifically, the study aimed to measure improvements in overall triage accuracy, as well as reductions in over-triage and under-triage rates for both adult and pediatric patients.

Methods

This study employed a pre-test/post-test design involving 31 participants. Participants completed an electronic pre-test consisting of 30 patient scenarios (20 adult and 10 pediatric) before attending a 40-minute didactic lecture on MCI triage principles. The lecture covered the identification of MCI …

Point Of Care Ultrasound For Rapid Identification Of Central Retinal Artery Occlusion And Subsequent Vision Rescue Utilizing Intravenous Alteplase, Joseph Pepe, Karl Kasischke, Calen Hart

Florida Journal of Emergency Medicine (FJEM)

Central retinal artery occlusion (CRAO) is a rare but critical diagnosis to make in patients with acute vision loss. Cases of central retinal artery occlusion historically have a poor prognosis due to delayed presentation, lack of early identification, and limited effective treatment options. Due to these challenges, patients are often left with permanent loss of vision.

We present a case of a male patient in his late 70s with sudden onset of loss of vision to the right eye. Identification of CRAO was made utilizing point of care ultrasound (POCUS). After discussion with neurology, the patient was treated with alteplase …

Development Of An Artificial Intelligence Web Based System For Classification Of Tomatoes Disease, Joshua Sokowonci Mommoh, Etinosa Noma-Osaghe, Vera Nimo Timai, Odike Arnold Uchechi, Solomon Obhenbhen Ibharunujele, Blessing Godday

Mansoura Engineering Journal

The development of this platform addresses the challenges associated with traditional tomato disease detection methods as well as the challenges of current machine learning and deep learning models in accurately detecting tomato diseases. Conventional methods of tomato disease diagnosis typically rely on expert evaluation but are time-consuming and susceptible to human mistakes. Incorrect diagnoses of certain diseases could lead to poor control measures, resulting in decreased agricultural productivity. In this research, the PlantVillage dataset, comprising 18,160 tomato leaf images distributed across 10 classes, was used to train two machine learning models, namely, Inception-ResNetV2 and Inception V3. The models were configured, …

Metamaterial-Based Microstrip Antenna For Safe Detection Of Tiny Breast Tumors, Shrouk E. El-Sawy, Mohamed G. Abdelfattah, Nihal F.F. Areed, Ahmed Shaban Samra

Mansoura Engineering Journal

This study describes the construction of a compact microstrip patch antenna (MPA) with a triangular-shaped metamaterial layer for the safe detection of tiny breast tumors at 2.4 GHz. The metamaterial considerably improves the antenna's gain and directivity when compared to typical designs that do not include it, resulting in improved detection performance. The radiating patch of proposed antenna measures 29.3 × 38 × 1.6 mm and has been tested through simulations and experimental tests, exhibiting successful tumor identification in a realistic breast phantom. The results of both calculations and testing demonstrate a sensitivity of 6.643 dB/mm, allowing for precise detection …

Hemiballismus Secondary To Acute Cerebrovascular Accident, Benjamin Duppstadt, Andres Vega, Jonathan Hill, David Arbona

Florida Journal of Emergency Medicine (FJEM)

Hemiballismus is a rare hyperkinetic movement disorder characterized by involuntary, large amplitude flinging movements. We present the case of a 61-year-old male with multiple comorbidities who arrived at the emergency department with acute-onset hemiballismus of the left upper extremity, ultimately found to be secondary to a right middle cerebral artery (MCA) infarct. This case underscores the importance of considering stroke in the differential for new-onset movement disorders, even in patients with seemingly psychiatric features and a nondiagnostic initial computed tomography (CT) scan.

Ultrasound-Guided Needle Aspiration Of A Peritonsillar Abscess In The Emergency Department, Elizabeth Piwowarski, Kenith Dsouza, Taryn Hoffman

Florida Journal of Emergency Medicine (FJEM)

Background

Peritonsillar abscess (PTA) is a relatively common diagnosis to encounter in the emergency department (ED). If untreated, PTA can lead to serious outcomes such as airway compromise, deep space infections and septicemia. Point of care ultrasound (POCUS) can be used by the emergency physician to confirm the suspected diagnosis, evaluate the size and depth of the abscess, and be used as a guide during needle aspiration.

Case

A 26-year-old male presented to the ED with a sore throat and was found to have a peritonsillar abscess on exam, which was confirmed using computerized tomography (CT) imaging. Providers were unable …

When Clotting And Bleeding Collide: A Case Of Bilateral Pe And Concurrent Upper Gi Hemorrhage, Tabitha D. Baca, David Rayburn, Daniel Castro, Jessica Aird

Florida Journal of Emergency Medicine (FJEM)

Introduction

Concurrent episodes of pulmonary emboli and gastrointestinal bleeding in one patient are not commonly seen. When a patient presents with both, it presents a challenge to manage as they are opposite ends of the same disease spectrum associated with the coagulation system.

Case Report

We present the case of a 65-year-old male who presented to our hospital via EMS with unknown prior history after a witnessed cardiac arrest, who on evaluation also had a concurrent bilateral pulmonary emboli with right heart strain.

Why should an emergency physician be aware of this?

While there is extensive research on the management …

Academic Ophthalmology Physician Financial Compensation In The United States: Trends And Distribution By Rank, Sex, Race/Ethnicity, And Geography, Sofia Miguez, Dheeman Futela, Victoria Marks, Jessica Chow, Ajay Malhotra

Journal of Academic Ophthalmology

Background: Despite diversity efforts, under-representation and compensation inequities persist in academic ophthalmology.

Purpose: To investigate the trends and distribution of academic ophthalmology physician financial compensation in the United States and compare them by rank, sex, race/ethnicity of faculty, and geographic location of programs. Methods: This was a cross-sectional, retrospective study of the compensation of full-time ophthalmology faculty with a medical doctorate or equivalent degree at U.S. medical schools from 2017 to 2023. This national study uses data from the AAMC Faculty Salary Report. The main outcome measure was total compensation. Total compensation was analyzed by faculty rank …

Analyzing The Research Publications Of Successful Ophthalmology Residency Matches In 2024: Trends, Impact, And Outcomes, Ethan Abizadeh, Aaron Abizadeh, Aaron Lavi, Eli Berglas, David Musheyev, Hadar K. Shimshon, Julia Glatman, Neekoo Farahmandpour, Matthew A. Wilneff, John J. Laudi

Journal of Academic Ophthalmology

Purpose: To analyze the quantity and quality of research publications of medical students who matched into the top 25 ophthalmology programs in the 2024 cycle and compare these results to previous match cycles.

Methods: This was a retrospective cross-sectional study. Participants included matriculating ophthalmology residents attending the top 25 programs as determined by Doximity. The Doximity Residency Navigator website was used to determine which programs were ranked in the top 25 in the country, and several websites were used to determine which students matched at the top 25 residencies. Once these students were identified, their research publications were …

Evaluating The Diagnostic Accuracy Of Ophthalmology Residents: Balancing Resident Autonomy With Patient Safety, Charles Zhang, Sinan Ersan, Timothy-Paul H. Kung, Yousef Yousef, Margaret M. Deangelis, Andrew L. Reynolds

Journal of Academic Ophthalmology

Background: Ophthalmology residency programs aim to cultivate competent, independent-thinking ophthalmologists. However, achieving a balance between resident autonomy and patient safety presents a difficult challenge.

Purpose: To evaluate the diagnostic accuracy and safety of a resident-driven on-call model, wherein consulting with a senior resident or attending physician is at the discretion of a postgraduate year 2 or 3 resident.

Methods: This was a retrospective study evaluating emergency department ophthalmology consultations at Erie County Medical Center, a level one trauma center in Western New York, between 1 January 2019 and 31 December 2021. Resident diagnoses and critical examination findings …

Teaching Slit Lamp Funduscopy With A Self-Guided E-Learning Module With Model Eye And Validation Of A Self-Assessment Tool, Irene Pak, Isabell Kassaye, Adam Alyafaie, Albert Xu, Neeti Parikh, Madeline Yung

Journal of Academic Ophthalmology

Background: Slit lamp funduscopy is an essential diagnostic tool used by ophthalmologists to visualize the posterior structures of the eye. However, the fast-paced nature of outpatient care in ophthalmology often limits preceptor teaching opportunities for medical students during clerkships. This challenge is exacerbated by the minimal preclinical exposure to ophthalmology and the technical complexity of the slit lamp examination. Therefore, curricular reform is needed to improve medical student competency in ophthalmic examination skills.

Purpose: To develop a self-guided e-learning module to teach medical students slit lamp funduscopy and evaluate a self-assessment tool for slit lamp funduscopy skills.

Methods …

Potential Cost Savings At A Single Tertiary Care Center Through Implementation Of A 340b-Compliant Multiuse Drop Protocol For Cataract Surgery, Carla Baaklini, Sabrina Duong, Jieon Jenny Kim, Samer Hajji, Aaron D. Webel

Journal of Academic Ophthalmology

The University of Missouri Healthcare system is seeking to implement a multiuse drop protocol for cataract surgeries, allowing preoperative eye drop bottles to be utilized for multiple patients rather than being discarded after single use. This presents an opportunity for reducing medical waste and achieving considerable cost savings. A key challenge, however, lies in maintaining compliance with the 340B Drug Pricing Program, which currently limits our ability to fully adopt this practice. We additionally encountered barriers including infection control concerns and staff adaptation to new workflows. We detail the barriers we have encountered thus far and present a potential 340B-compliant …

Evaluating Ergonomics Education In United States Ophthalmology Residency Programs, Simran Ohri, Changseok Lee, R. Rishi Gupta, Alice Y. Zhang

Journal of Academic Ophthalmology

Background: Musculoskeletal disorders are prevalent among ophthalmologists because of occupational risks that include repetitive movements and uncomfortable postures. Teaching proper ergonomic practices early in an ophthalmologist’s career may help avoid outcomes such as chronic pain and early retirement.

Purpose: To investigate the level of formal ergonomics education in U.S. ophthalmology residencies.

Methods: An Association of University Professors of Ophthalmology (AUPO) approved survey was distributed to program directors and coordinators of 113 residency programs via the AUPO email listserv.

Results: The survey had a response rate of 33.6%. Of the 38 programs that responded, only 13 (34.2%) …

Womeninophthalmology: Gender Diversity In Ophthalmology Residency Program Social Media, Aretha Zhu, Jasmine Mahajan, Owais M. Aftab, Tyler P. Steidl, Daniela Yakobashvili, Priya Tailor, Rashika Verma, Catherine Ye, Rose S. Maisner, Miriam Habiel

Journal of Academic Ophthalmology

Purpose: Although women constitute a significant portion of medical students and physicians, representation of women in ophthalmology is relatively low. Residency programs are increasingly using social media to showcase and represent their program culture. The purpose of this retrospective cross-sectional study was to assess representation of gender diversity in social media posts by U.S. ophthalmology residency programs.

Methods: Instagram, Facebook, and TwitterTwitter/X accounts of ophthalmology residency programs accredited by the Accreditation Council for Graduate Medical Education were identified. Social media posts from 2019-2021 were analyzed for representation of gender diversity and/or explicit statements regarding gender diversity. Program metrics, including geographic …

Pilot For A Virtual Regional Ophthalmic Health Disparities Journal Club For Pre-Medical And Medical Students: A Three-Year Analysis, Bridget Croniger, Ariane Kaplan, Anjali R. Shah, Chaesik Kim, Rachel Riddle, Tannia M. Rodriguez, Anju Goyal

Journal of Academic Ophthalmology

Background: Social determinants of health influence ophthalmic health outcomes in the United States. Understanding these factors is crucial for current and future physicians, but there is no standardized curriculum to teach learners about this topic.

Purpose: This pilot study evaluated the impact of three virtual regional ophthalmic health disparities journal clubs on pre-medical and medical students’ understanding of ophthalmic health disparities, interest in ophthalmology, and comfort in appraising medical literature.

Methods: Three annual virtual journal clubs were held in 2022, 2023, and 2024. Each session featured a different peer-reviewed published article related to ophthalmic health disparities as well …

Pilot And One-Year Follow-Up Of A Novel Hybrid Ophthalmology Elective Course For Preclinical Students, Amina Avril, Jason J. Jo, Jessica Tran, Claire Ufongene, Samira Farouk, Nisha Chadha

Journal of Academic Ophthalmology

Background: Preclinical elective courses, particularly in a hybrid format, may facilitate ease of access, increase exposure, and build interest in ophthalmology.

Purpose: To evaluate knowledge acquisition and interest in ophthalmology immediately after and 1 year after implementing a novel elective course.

Methods: We developed an optional, 8-session, hybrid elective course based on the American Academy of Ophthalmology objectives for medical students. The course included virtual didactics and in-person skills sessions. Each virtual session focused on an ophthalmic subspecialty and consisted of a facilitated case review followed by an interactive career-related discussion with a faculty member practicing that …

Ophthalmology At The Veterans Health Administration: How Sex And Other Factors Affect Salary, Tyler J. Carman, David H. Parkinson, Nabiha B. Habib, Charles W. Ryan, Danielle T. Dupuis, Julie M. Rosenthal, Denise S. Kim, Denise A. John, Alejandra M. Maiz, Rajesh C. Rao

Journal of Academic Ophthalmology

Purpose: To determine factors that contribute to current salary differences among ophthalmologists employed by the Veterans Health Administration (VHA).

Methods: We performed a cross-sectional analysis of full-time equivalent salaries of Veterans Health Administration ophthalmologists who received a federal salary in 2021. Differences in average salary with respect to various demographic variables were analyzed.

Results: Data for 632 salaried VHA ophthalmologists (262 females [41.5%]) were included. Although biological sex alone did not have a crude, statistically significant effect on average VHA ophthalmologist salary (p = 0.116), a substantial discrepancy was noted in adjusting for other significant demographic …

Infographic: Top Sports For Children, Dominique Russell

Teacher infographics

What sports options are on offer at your school for 2026? Today’s infographic might serve up some inspiration. It outlines the most popular organised sports participated in outside of school hours, by age group. The data show activities such as gymnastics and swimming lessons are popular at a younger age, and participation in team sports becomes more popular in older age groups.